On the Issues: Fighting Infectious Diseases

On the Issues: Fighting Infectious Diseases


(gentle music) – With me today is Professor Albert Ko who serves as chair of our Department of Epidemiology of Microbial Diseases. His expertise includes infectious diseases of underserved urban areas, particularly the city
where he’s worked for over a quarter-century, Salvador, Bahia, Brazil. Well, tell us first a little bit about the circumstances in which you found yourself with the Zika outbreak. – So, Sten, you know the, where we’ve been working
for the last twenty-five years in Salvador, Brazil, which is the Northeast region of the country, was the epicenter for the Zika epidemic. The major problems that we’re dealing with now are really twofold, one is that all the babies who had developed these severe birth defects, the microcephaly, the small heads, but all the pathology behind that, or underneath that. And then the second is, is all the babies who were born during that outbreak, or during that epidemic, who were presumably exposed, didn’t have this severe birth defects, and, but may have more subtle, but equally important, you know, deficits as they go on into preschool and school, kindergarten, that neurocognitive developmental defects that may happen. Those are the big questions that we’re trying to grapple with right now. – [Sten Vermund] What about the day-to-day lives of Brazilians? Who gets Leptospirosis, and how do they get it? – Leptospirosis is an old problem. It’s an old problem that has been intimately intertwined with poverty, whether it’s rural-based, rural poverty, such as
subsistence farmers, or whether it’s urban slum-dwellers, as you know, the, the major transformations of our society in the last twenty, thirty years has been rapid urbanization, the growth of cities, the expansion of urban slum communities. The most successful species in these environments, ecologically, are not the humans, but actually rats, the domestic rats, the
Norway or sewage rats, or the black rat, and these are reservoirs for transmission of this bacterial disease, life-threatening bacterial disease, which causes up to forty percent case fatality, in people who have been, who have been infected, severe pulmonary bleeding, sepsis. – [Sten] What about Dengue and Zika, what are their links to poverty, if any, since the mosquitoes are far more democratic, and will bite anyone who’s available? – So, obviously the, the major impact of this epidemic, whether it’s due to Zika virus or Dengue or Leptospirosis, is always going to be
greater among the poorer, marginalized populations. – [Sten] There are diseases that we expect, that are largely unknown, that could emerge, and I read about the gobbling up of the vast Amazon Rainforest with settlers, folks who who clear the land and and who bring humans closer and closer to the rainforest. Do you think that will be a source of new viruses or new diseases that come into man from the animal world? – So, yes, Sten, I think that’s an important point. When we look back at the important, emerging infections,
whether it’s Nipah virus or SARS, or Ebola, many of these were zoonotic infections. I think the best example comes from your home territory of HIV, these were zoonotic
infections that spilled over to human populations. The big challenge that we have is, what’s going to be the next HIV, SARS, or MERS, or Ebola that comes out. – [Sten] So, what
exactly are we doing here in Epidemiology of Microbial Diseases, the School of Public Health, what are we doing with the state that is keeping an eye
on our own backyard? – [Albert] What we’re
able to do with this, and because we have this
unique collaboration between public health practitioners and academicians, is that we can bring in new methodologies. And one good example is the modelers, the mathematical modelers, that we’re able to do to help this state make more robust predictions on, bird, disease bird and
outbreaks interventions. – [Sten] Well, I have appreciated this conversation, obviously topics close to my heart, and my interests, but, we really value the work of our somewhat unique Department of Epidemiology of Microbial Diseases, and your leadership with that department, so thanks for your time. – Well, it’s been a privilege. And thank you very much
for the opportunity, Sten, to talk to you.

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